Endoscopic Factors Influencing Fecal Calprotectin Value in Crohn's Disease
Endoscopic Factors Influencing Fecal Calprotectin Value in Crohn's Disease
复制标题
DOI：
10.1093/ecco-jcc/jjv150
复制
发表时间：
2015-12-01
影响因子：
8
通讯作者：
Buisson, A.
中科院分区：
文献类型：
--
作者：
Goutorbe, F.;Goutte, M.;Buisson, A.
背景和目的：粪便钙卫蛋白[fcal]是克罗恩病[CD]内镜活动的生物标志物。确定fcal不太可靠的内镜情况仍然没有探索。我们的目的是确定内镜因素影响fcal水平在CD。方法：总体而言，53 CD患者连续和前瞻性进行结肠镜检查，与CD内镜严重程度指数[CDEIS]计算和粪便收集。使用定量免疫层析试验测量Fcal。结果：Fcal与CDEIS呈显著正相关[0.66，p < 0.001]。在单变量分析中，fcal与受影响表面[0.65，p < 0.001]和溃疡表面[0.47，p < 0.001]相关。Fcal与溃疡深度显著相关，非溃疡性病变、浅表溃疡[SU]和深层溃疡[DU]患者的中位fcal分别为867.5 μ g/g、1251.0 μ g/g和1800.0 μ g/g。病变部位不影响fcal。在多变量分析中，fcal与受累表面[p = 0.04]和CD病变的存在相关。此外，fcal随溃疡深度增加而增加[p = 0.03]。然而，溃疡表面和CD位置不影响fcal。使用受试者操作特征[ROC]曲线，我们发现fcal为400 μ g/g是灵敏度[0.76]和特异性[0.77]之间的最佳折衷，而fcal >= 200 μ g/g对检测SU或DU高度敏感[0.86]。结论：Fcal是检测CD内镜下溃疡的非常可靠的生物标志物。我们建议在日常实践中重复测量中间结果[200-400 μ g/g]。Fcal水平主要受CD病变[甚至非溃疡性]的影响，以深度相关方式和受影响表面。
Background and Aims: Fecal calprotectin [fcal] is a biomarker of Crohn's disease [CD] endoscopic activity. Identifying the endoscopic situations in which fcal is less reliable remains unexplored. We aimed to determine the endoscopic factors influencing fcal level in CD.Methods: Overall, 53 CD patients consecutively and prospectively underwent colonoscopy, with CD Endoscopic Index of Severity [CDEIS] calculation and stool collection. Fcal was measured using a quantitative immunochromatographic test. Correlation analysis was done with Pearson statistics.Results: Fcal was correlated with CDEIS [0.66, p < 0.001]. In univariate analysis, fcal was correlated with the affected surface [0.65, p < 0.001] and the ulcerated surface [0.47, p < 0.001]. Fcal was significantly associated with ulceration depth, with median fcal of 867.5 mu g/g, 1251.0 mu g/g, and 1800.0 mu g/g, in patients presenting with non-ulcerated lesions, superficial ulcerations [SU], and deep ulcerations [DU], respectively. Lesion locations did not influence fcal. In multivariate analysis, fcal was associated with affected surface [p = 0.04] and the presence of CD lesions. Moreover, fcal increased with the ulceration depth [p = 0.03]. However, ulcerated surface and CD location did not affect fcal. Using a receiver operating characteristic [ROC] curve, we showed that fcal of 400 mu g/g was the best compromise between sensitivity [0.76] and specificity [0.77], whereas fcal >= 200 mu g/g was highly sensitive [0.86] to detect SU or DU.Conclusions: Fcal is a very reliable biomarker to detect endoscopic ulcerations in CD. We suggest repeating measurement in case of intermediary results [200-400 mu g/g] in daily practice. Fcal level is mostly influenced by the presence of CD lesions [even non-ulcerated], in a depth-related manner and by the affected surface.